NR-547 Study Guide Question with 100%
Verified Answers
medications taken at night for sedating side effect
"atypical" antipsychotics like quetiapine (Seroquel) or olanzapine (Zyprexa), can cause
significant drowsiness
Paroxetine taken once at bedtime
medications taken with food
metformin (reduce GI effects )
Lurasidone with at least 350 calories for medication effectiveness
Lithium and valproic acid (Depakote) often cause gastrointestinal upset, which can be
mitigated by taking them with food, and sometimes a split dose
Enuresis
DSM-5-TR Criteria (key points): ≥2 episodes/week for ≥3 months OR significant
distress/impairment; age ≥5 years; not due to substance/medical condition.
Types: Nocturnal: Only at night (most common). Diurnal: Only during
day. Mixed: Both. Primary: Never achieved control. Secondary: Lost control after ≥6
months of dryness.
Common Treatment: Behavioral (alarms, fluid restriction) & Pharmacological
(Desmopressin, Imipramine).
Erectile dysfunction...statistics, causes and treatments
,Around 40% of men are affected by age 40.
Around 70% of men report ED by age 70
Vascular Issues: Insufficient blood flow into the penis
High prolactin levels
Antidepressants (especially SSRIs)
Antihypertensives (e.g., beta-blockers, diuretics)
Antihistamines
Opioids
Sedatives
Oral Medications (Phosphodiesterase-5 (PDE5) Inhibitors - First-line pharmacologic):
eg Sildenafil (Viagra) ""fils"
Important Note: Contraindicated with nitrates
Alprostadil: Can be administered as a penile injection
· Obtaining a sexual history.
Principles: Privacy, non-judgmental, routine, open-ended questions, permission-seeking,
clear language.
Components (The "5 Ps"): Partners: Number, gender, new/established. Practices: Types
of sexual activity (vaginal, oral, anal). Protection from STIs: Condom use, STI testing,
vaccinations (HPV, Hep B). Past History of STIs: Any previous STIs,
treatment. Prevention of Pregnancy: Contraception use, pregnancy intentions.
,Purpose: Assess sexual health, identify risks (STIs, pregnancy), address dysfunction, build
rapport, inform care.
Female Sexual Interest/Arousal Disorder (FSIAD)
Lack of sexual thoughts/fantasies.
Decreased initiation of sexual activity.
Reduced excitement/pleasure during sexual activity.
Absent/reduced response to internal or external sexual cues.
Reduced genital or non-genital sensations during sexual activity.
Diagnosis: Requires at least 3 of the above symptoms for at least 6 months, causing
significant distres
Female Orgasmic Disorder
Symptoms: Marked difficulty, delay in, or absence of achieving orgasm despite adequate
sexual arousal and stimulation.
Diagnosis: Requires persistent or recurrent difficulty achieving orgasm in almost all (75-
100%) sexual encounters, lasting at least 6 months, and causing significant distress.
Genito-Pelvic Pain/Penetration Disorder (GPPPD):
Symptoms: Persistent or recurrent difficulties with one or more of the following:
1. Vaginal penetration during intercourse.
2. Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.
3. Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a
result of vaginal penetration.
, 4. Marked tensing or tightening of the pelvic floor muscles during attempted vaginal
penetration.
Diagnosis: Requires at least one of these symptoms for at least 6 months, causing significant
distress.
causes of female sexual dysfunction
Physical: Hormonal (menopause, pregnancy), medical conditions (diabetes, heart disease),
medications (antidepressants), gynecological issues.
Psychological: Depression, anxiety, stress, trauma. Relationship: Communication, partner
dysfunction. Sociocultural: Beliefs, lack of education.
treatments for female sexual dysfunction
Flibanserin (Addyi): Oral medication taken daily at bedtime. Acts on serotonin receptors.
(Note: Interactions with alcohol and certain antifungals).
Bremelanotide (Vyleesi): Self-administered injection taken prior to sexual activity.
Activates melanocortin receptors.
Other Medications (sometimes used off-label or for specific issues): Bupropion
(Wellbutrin) for desire (especially if antidepressant-induced FSD). Ospemifene (Osphena):
Oral medication for painful sex due to Genitourinary Syndrome of Menopause (GSM). GSM.
Prasterone (Intrarosa): Vaginal insert for painful sex due to Genitourinary Syndrome of
Menopause (GSM).
Flibanserin
Serotonin 1A receptor agonist and serotonin 2A receptor antagonist (often described as a
"multifunctional serotonin agonist and antagonist" or MSAA). It's sometimes called a
Verified Answers
medications taken at night for sedating side effect
"atypical" antipsychotics like quetiapine (Seroquel) or olanzapine (Zyprexa), can cause
significant drowsiness
Paroxetine taken once at bedtime
medications taken with food
metformin (reduce GI effects )
Lurasidone with at least 350 calories for medication effectiveness
Lithium and valproic acid (Depakote) often cause gastrointestinal upset, which can be
mitigated by taking them with food, and sometimes a split dose
Enuresis
DSM-5-TR Criteria (key points): ≥2 episodes/week for ≥3 months OR significant
distress/impairment; age ≥5 years; not due to substance/medical condition.
Types: Nocturnal: Only at night (most common). Diurnal: Only during
day. Mixed: Both. Primary: Never achieved control. Secondary: Lost control after ≥6
months of dryness.
Common Treatment: Behavioral (alarms, fluid restriction) & Pharmacological
(Desmopressin, Imipramine).
Erectile dysfunction...statistics, causes and treatments
,Around 40% of men are affected by age 40.
Around 70% of men report ED by age 70
Vascular Issues: Insufficient blood flow into the penis
High prolactin levels
Antidepressants (especially SSRIs)
Antihypertensives (e.g., beta-blockers, diuretics)
Antihistamines
Opioids
Sedatives
Oral Medications (Phosphodiesterase-5 (PDE5) Inhibitors - First-line pharmacologic):
eg Sildenafil (Viagra) ""fils"
Important Note: Contraindicated with nitrates
Alprostadil: Can be administered as a penile injection
· Obtaining a sexual history.
Principles: Privacy, non-judgmental, routine, open-ended questions, permission-seeking,
clear language.
Components (The "5 Ps"): Partners: Number, gender, new/established. Practices: Types
of sexual activity (vaginal, oral, anal). Protection from STIs: Condom use, STI testing,
vaccinations (HPV, Hep B). Past History of STIs: Any previous STIs,
treatment. Prevention of Pregnancy: Contraception use, pregnancy intentions.
,Purpose: Assess sexual health, identify risks (STIs, pregnancy), address dysfunction, build
rapport, inform care.
Female Sexual Interest/Arousal Disorder (FSIAD)
Lack of sexual thoughts/fantasies.
Decreased initiation of sexual activity.
Reduced excitement/pleasure during sexual activity.
Absent/reduced response to internal or external sexual cues.
Reduced genital or non-genital sensations during sexual activity.
Diagnosis: Requires at least 3 of the above symptoms for at least 6 months, causing
significant distres
Female Orgasmic Disorder
Symptoms: Marked difficulty, delay in, or absence of achieving orgasm despite adequate
sexual arousal and stimulation.
Diagnosis: Requires persistent or recurrent difficulty achieving orgasm in almost all (75-
100%) sexual encounters, lasting at least 6 months, and causing significant distress.
Genito-Pelvic Pain/Penetration Disorder (GPPPD):
Symptoms: Persistent or recurrent difficulties with one or more of the following:
1. Vaginal penetration during intercourse.
2. Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.
3. Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a
result of vaginal penetration.
, 4. Marked tensing or tightening of the pelvic floor muscles during attempted vaginal
penetration.
Diagnosis: Requires at least one of these symptoms for at least 6 months, causing significant
distress.
causes of female sexual dysfunction
Physical: Hormonal (menopause, pregnancy), medical conditions (diabetes, heart disease),
medications (antidepressants), gynecological issues.
Psychological: Depression, anxiety, stress, trauma. Relationship: Communication, partner
dysfunction. Sociocultural: Beliefs, lack of education.
treatments for female sexual dysfunction
Flibanserin (Addyi): Oral medication taken daily at bedtime. Acts on serotonin receptors.
(Note: Interactions with alcohol and certain antifungals).
Bremelanotide (Vyleesi): Self-administered injection taken prior to sexual activity.
Activates melanocortin receptors.
Other Medications (sometimes used off-label or for specific issues): Bupropion
(Wellbutrin) for desire (especially if antidepressant-induced FSD). Ospemifene (Osphena):
Oral medication for painful sex due to Genitourinary Syndrome of Menopause (GSM). GSM.
Prasterone (Intrarosa): Vaginal insert for painful sex due to Genitourinary Syndrome of
Menopause (GSM).
Flibanserin
Serotonin 1A receptor agonist and serotonin 2A receptor antagonist (often described as a
"multifunctional serotonin agonist and antagonist" or MSAA). It's sometimes called a
